I got on the phone with a nearby board-certified veterinary neurologist and said to her, "I'm pretty sure I have a dog with either meningitis or an acute disc prolapse."
"She probably too young for a disc," she told me, "she has meningitis." After discussing with the owner the likely diagnosis and quote for a referral for a CSF-tap (an important analysis of the fluid surrounding the brain and spinal cord), the owner elected to have me treat the dog and declined the referral due to its high cost. The neurologist gave specific doses for steroids (dexamethasone) and antibiotics should the owner not be able to make the referral.
The dog responded within four hours of treatment, and walked out of the clinic with much more ease than when she was presented to me. She continues to improve.
The dog likely has steroid-responsive meningitis, or auto-immune meningitis, where the body produces antibodies against its own tissues and this produces a massive inflammatory response. It is unknown why this occurs. Antibiotics were used in this case because a CSF-tap was not performed, making bacterial meningitis a possibility as well.
Meningitis can occur because of viruses, bacteria, fungi, and parasites, as well as different types of steroid-responsive meningitides (the plural of meningitis), as discussed above. Pugs get their own type of meningitis, called granulomatous meningo-encephalitis (or GME), for which steroids are used in its treatment. There are other breed-specific types of the disease.
Interesting case, but I'd rather treat an ear infection than meningitis given the much better prognosis with the former.
Collecting cerebrospinal fluid from a dog requires practice and technical skill.
6 comments:
I enjoy the stories where the history sends you on the wrong track... at least the ones with happy endings. It really shows how important detective work is in diagnosis and how a good diagnostician keeps an open mind.
Your blog is an inspiration to me :)
Lilliana
Lilliana,
Your comment is an inspiration to me.
I just read your blog...my chocolate lab was diagnosed with steroid responsive meningitis at 9 months old also. She had a very high fever, but no symptoms. The vet diagnosed her with fever of unknown origin (it went up to 106.1). Then after being hospitalized for two days she came home where she developed symptoms that you described. She couldn't move her neck and she was really weak and couldn't even go up the stairs or sit down. We took her to the ER at University of Penn and they thought she had meningitis. We did opt for the testing and she was given a spinal tap, which showed that she had meningitis. Now she has to take steroids for 6 months! Have you seen many cases meningitis? A question to you...any suggestions on the peeing? The steroids are making her pee herself and pee all over my house. We let her out at least once an hour but she still seems to pee in the house. I don't know if I can take six months of this!!! Help me! My husband and I love our dog Hershey to death and would do anything to help her!!
Can a dog get auto Immune meningetis from a bad reaction to a 3year Rabie shot? My 5 year old French Bulldog had a 3 year Rabies in August, and began to slow down, not want to go for walks, could not jump on sofa, by December he had glazed look, shaking head, licking paws, back end collapse...he went into emergency for MRI and we ruled out tumors, had spinal tap and found auto immune...he is now on steroids, and antibiotics with Pheno barbital for 30 days. will he recover? will he have to stay on steroids???
It's possible, but impossible to prove. Many dogs develop auto-immune disease without having been vaccinated so no studies showing any correlation. I hope he recovers fully.
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